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DE/EMC Permission Form
Date of Birth:
- must be mm/dd/yyyy format
Date Format: MM slash DD slash YYYY
Bronson High School
Burr Oak High School
Centreville High School
Colon High School
Constantine High School
Gull Lake High School
Mendon High School
Quincy High School
Schoolcraft High School
Sturgis High School
Three Rivers High School
Three Rivers Partnership
Union City High School
White Pigeon High School
Other High School
If student is an EMC student please enter 5th year graduation year.
Disclaimer (please read before submitting form)
By submitting this form, I agree to my son/daughter enrolling in college coursework with Glen Oaks Community College for the 2021-2022 Academic Year. The statements below pertain to the responsibilities and guidelines of my son/daughter by taking advantage of this program.
I do not have access to my son/daughter’s records unless they authorize me to do so by filling out a FERPA form, handled through the college.
That by participating in the Glen Oaks NOW! Program, my son/daughter will begin/continue their college academic record. All grades earned will be part of their Glen Oaks Community College transcript.
That course selection is important. My son/daughter will need to seek out information from other institutions if they have a desire to attend an alternate college after high school graduation. I also understand that transferability is dependent on the receiving institution and program requirements, and my son/daughter must have a 2.0 or better.
That my son/daughter will be held responsible for paying all tuition and fees not covered by their high school. In the instance that they fail a course or drop after the refund period, they may also be responsible for reimbursing the high school.
Course dates, times, and delivery methods vary by course/semester and it is my son/daughter’s responsibility to know when classes begin, where they are held, and transportation to get there. Also, that these classes may run on a schedule different than their high school and they will follow the calendar of the location of the class.
College courses may expose my son/daughter to topics or conversations that include adult-themed material.
My son/daughter will have their own Glen Oaks email address and a student ID number, used to login to the Student portal (myGOCC) where they can access their schedule, grades and other important student information.
My son/daughter needs to inform their counselor if they want to add or drop a course from their schedule and that a Change of Schedule Form must be completed in Etrieve in order to do so.
My son/daughter will need to abide by the Glen Oaks policies and procedures while enrolled.
My son/daughter will need to seek out the helpful videos/tutorials available to them on the High School Options page of the GOCC website, should they need more clarification on a process or procedure.
By participating in this program, my son/daughter has allowed for the release of any records from their high school, if required by the college, and the sharing of their college academic progress, attendance, and grades with the high school.
*This form is not complete until it is signed!
Upon clicking the Submit button, you will be redirected to a populated version of this form that will require your digital signature (this is a legal signature). After signing the form you will have the option to print the form or save a digital copy of it in PDF format.
This field is for validation purposes and should be left unchanged.
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